Before you can sell Medicare plans as a licensed insurance agent, you need to complete tests and training, including the AHIP certification. Here is what you need to know about getting AHIP certified.
What is AHIP?
America’s Health Insurance Plans (AHIP) certification is how insurance agents prove to Medicare that they understand the basics of Medicare plans and how to be a compliant agent. The Centers for Medicare & Medicaid Services (CMS), which oversees those programs, CHIP, and the health insurance marketplaces, requires agents to complete the certification, as do most plan carriers. If you want to sell Medicare Advantage and Prescription Drug Plans, you need to get the Medicare AHIP certification.
AHIP Medicare
The Medicare certification test checks your knowledge and understanding of the plans and how to operate compliantly as an agent. You can expect to be tested on: fee-for-service eligibility and benefits; Medicare Advantage plan types; Part D Prescription Drug Plan types; eligibility for and coverage of Medicare plans; marketing and enrollment requirements; nondiscrimination training; and more.
AHIP Fraud Waste and Abuse (FWA)
Stay up to date with Medicare regulations for fraud detection and reporting with the FWA training. This training will cover: how to identify fraud, waste and abuse; how the industry detects fraud; the human and financial cost of fraud; general compliance requirements for Medicare FWA; who commits FWA; how to report FWA; and more.
About the AHIP Test
Agents who have a thorough understanding of Medicare will have no trouble with AHIP certification because it is an open book test. You take the test online through the AHIP website and have two hours to complete 50 questions.
The test costs $175, which purchases you three attempts to pass. If you do not pass both parts of the test during those first three attempts, you will need to pay another $175 for more attempts.
You can study for the test through online self-study courses or trainings that go over the covered Medicare topics.
How to Take the AHIP Test
Register to take the Medicare AHIP test through the AHIP website. You can set up your account with your National Producer Number and a password.
Once you pass the test and receive the AHIP certification, you upload the certification to each carrier’s website to prove your compliance. Your carriers will require you to retake the AHIP test every year. Study to pass in the first three attempts or you may not be approved to sell for that certification year.
